RESULTS AND COMPLICATIONS OF TOTAL HIP ARTHROPLASTIES IN PATIENTS WITH SICKLE-CELL HEMOGLOBINOPATHIES - ROLE OF CEMENTLESS COMPONENTS

The complications and results of 16 primary and revision total hip art hroplasties in patients with sickle-cell hemoglobinopathies were evalu ated. One patient died from renal failure at 1 year, leaving 15 hips i n 10 patients for review at a mean follow-up period of 6 years (range, 2-12 years). There were 7 cementless primary total hip arthroplasties and 8 revision arthroplasties, 6 of which were uncemented. Patients w ere evaluated clinically using a standard hip rating system and radiog raphically using accepted criteria. There were no early or late deep i nfections; however, 7 of 8 primary arthroplasties and 5 of 8 revisions had one or more early complications. No cementless component demonstr ated loosening; however, there was asymptomatic polyethylene wear in 2 primary arthroplasties, treated with grafting and liner exchange, and femoral osteolysis was present in 4 of 13 cementless arthroplasties, one of which was revised to permit extensive grafting. Of the original 15 arthroplasties performed by the senior author, 5 required some typ e of reoperation during the study. At most recent follow-up evaluation , no component in the study was radiographically loose. In the hips th at did not require reoperation, the overall results were excellent in 6 hips, good in 3, and poor in 1 hip. Of the 5 hips requiring reoperat ion, the results were excellent in 3 hips, good in 1, and fair in 1 hi p at most recent follow-up evaluation. Cementless components should be considered for all primary and revision arthroplasties in patients wi th sickle-cell hemoglobinopathies, but early complications are frequen t and a high incidence of polyethylene wear and osteolysis requiring r eoperation may be expected.